- VA Announces Expansion of "Close to Me" Cancer Program as Part of the Cancer Moonshot, Bringing Cancer Diagnosis and Treatment Closer to Thousands of Veterans
- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Across the Country, Amish Populations Are on the Rise
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
How Rural Communities Are Losing Their Pharmacies
Batson’s Drug Store seems like a throwback to a simpler time. The independently owned pharmacy in Howard, Kansas, still runs an old-fashioned soda counter and hand-dips ice cream. But the drugstore, the only one in the entire county, teeters on the edge between nostalgia and extinction.
Julie Perkins, pharmacist and owner of Batson’s, graduated from the local high school and returned after pharmacy school to buy the drugstore more than two decades ago. She and her husband bought the grocery store next door in 2006 to help diversify revenue and put the pharmacy on firmer footing.
But with the pandemic exacerbating the competitive pressures from large retail chains, which can operate at lower prices, and from pharmaceutical intermediaries, which can impose high fees retroactively, Perkins wonders how long her business can remain viable.
She worries about what will happen to her customers if she can’t keep the pharmacy running. Elk County, with a population of 2,500, has no hospital and only a couple of doctors, so residents must travel more than an hour to Wichita for anything beyond primary care.
“That’s why I hang on,” Perkins said. “These people have relied on the store from way before I was even here.”
Corner pharmacies, once widespread in large cities and rural hamlets alike, are disappearing from many areas of the country, leaving an estimated 41 million Americans in what are known as drugstore deserts, without easy access to pharmacies. An analysis by GoodRx, an online drug price comparison tool, found that 12% of Americans have to drive more than 15 minutes to reach the closest pharmacy or don’t have enough pharmacies nearby to meet demand. That includes majorities of people in more than 40% of counties.
From 2003 to 2018, 1,231 of the nation’s 7,624 independent rural pharmacies closed, according to the University of Iowa’s Rural Policy Research Institute, leaving 630 communities with no independent or chain retail drugstore.
COVID-19 Medicaid and CHIP Data Snapshot through May 2021
The Centers for Medicare & Medicaid Services (CMS) is highlighting the impacts of the COVID-19 public health emergency (PHE) on families and individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) through the COVID-19 data snapshot release.
The snapshot includes data from March 2020 through May 2021 for reproductive health services; services delivered via telehealth; service use among beneficiaries who are 18 years of age and under; services for mental health; substance use disorders (SUD); and COVID-19 testing, treatment, and care services.
Many Medicaid and CHIP services have returned to pre-pandemic levels. but there are still services needed to make up for those missed during the COVID-19 PHE. CMS continues to partner with states to monitor data to ensure families and individuals have the access they need to critical health care services such as perinatal, mental health, and pediatric services.
To view the Medicaid and CHIP Data Snapshot, please visit https://www.medicaid.gov/stateresource-center/downloads/covid19-data-snapshot-11122021.pdf
Changes to Nursing Home Visitation COVID-19 (Revised) and COVID-19 Survey Activities
The Centers for Medicare & Medicaid Services (CMS) is continuing to promote health and safety and address the impacts of the COVID-19 public health emergency (PHE) on nursing home residents and their families by issuing memos that revise guidance for nursing home visitation and address the backlog of complaint and recertification surveys.
The first memo, Nursing Home Visitation – COVID-19 (Revised), issues revised visitation guidance in nursing homes. Together with infection prevention safeguards, including the recent staff vaccination regulation, this guidance will promote resident health and ensure continued safety as facilities continue to open. Early in the pandemic, visitation restrictions were implemented to mitigate the risk of visitors introducing COVID-19 to the nursing home. Today’s guidance update reflects that, while visitors, residents, or their representatives should be made aware of the risks associated with visiting loved ones, visitation should now be allowed for all residents at all times. CMS has consistently updated its visitation guidance through the COVID-19 PHE, and this update represents our most comprehensive action to bring residents and loved ones closer together. CMS continues to strongly encourage that everyone get vaccinated against COVID-19.
The second memo, Changes to COVID-19 Survey Activities, includes steps to assist State Survey Agencies (SAs) to address the backlog of facility complaint and recertification surveys. This backlog was the result of the temporary suspension and reprioritization of survey activity nationwide in the early days of the pandemic as CMS and states focused their efforts on infection prevention and control and controlling the spread of COVID-19. In recent months, states have made strong concerted efforts to resume recertification surveys, and we want that to continue.
Steps to assist SAs include:
- Revising the criteria for conducting COVID-19 Focused Infection Control (FIC) Surveys;
- Guidance for resuming recertification surveys; and
- Temporary guidance and minor flexibilities related to complaint investigations.
In addition, CMS is increasing oversight in nursing homes to provide a more focused review of quality-of-life and quality-of-care concerns. For example, the memorandum instructs surveyors to specifically review and focus additional attention to the competency of nursing staff, the use of any potentially inappropriate antipsychotic medications, and other areas of care, such as unplanned weight loss, loss of function/mobility, depression, abuse/neglect, or pressure ulcers.
To view the Nursing Home Visitation COVID-19 (Revised) memo, please visit: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/nursing-home-visitation-covid-19-revised.
To view the Changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes memo, please visit: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/changes-covid-19-survey-activities-and-increased-oversight-nursing-homes
Prenatal-to-3 Policy Impact Center Releases 2021 Policy Roadmap
The Prenatal-to-3 Policy Impact Center at The University of Texas at Austin LBJ School of Public Affairs released its 2021 Prenatal-to-3 State Policy Roadmap, which compares the investments states are making to support children and families. The roadmap is published annually for policy leaders and advocates to guide how each state can implement effective state-level policies and strategies that promote equity and measure the well-being of infants and toddlers. The guide also monitors each state’s progress toward implementing effective solutions for the prenatal-to-3 population.
The roadmap looks at five state-level policies and six strategies that positively impact one of eight prenatal-to-age-3 policy goals:
- Access to needed services
- Parents’ ability to work
- Sufficient household resources
- Healthy and equitable births
- Parental health and emotional well-being
- Nurturing and responsive child-parent relationships
- Nurturing and responsive child care in safe settings
- Optimal child health and development
Pennsylvania has successfully implemented one of the five state policies that impact one policy goal: expanded income eligibility for health insurance. Unfortunately, Pennsylvania has much more work to do in the other policy areas, including reduced administrative burdens for SNAP, and implementing legislation for paid family leave, an increased state minimum wage, and a state earned income tax credit.
Pennsylvania Partnerships for Children is working strategically with the Prenatal-to-Age-Three Collaborative to address some of the policy roadmap goals, policies, and strategies to serve our prenatal-to-age-3 population better. Under Early Learning PA, which includes Start Strong PA, Childhood Begins at Home, and Thriving PA, these statewide campaigns seek to put forward policies that positively make a difference in the lives of infants and toddlers, as well as their families. Using this roadmap and working with stakeholders, our goal is to increase access to high-quality services for infants and toddlers and their families by 50% by 2025.
CTE Fact Sheet Outlines Solutions for Increasing Access for Students
The Pennsylvania Partnerships for Children released Career and Technical Education is Essential for our Economy Post-COVID-19, a fact sheet produced with PA Schools Work coalition partner the Pennsylvania Association of Career & Technical Administrators (PACTA), outlining the impacts of the pandemic on CTE programs, which are essential for our state’s workforce and economy. The fact sheet includes the results of a survey conducted earlier this year by PPC on PACTA members to understand better the challenges they face in delivering education during the public health crisis.
While federal stimulus funds received from Washington over the past year have helped address one-time costs – including additional expenses associated with equipment in delivering CTE – state investments over the past two years have stalled. We highlight how access to these programs has not improved and the timing because CTE is a pipeline for many industries that supply the frontline workforce. To ensure that all interested students have an opportunity to access career and technical education, we call on Governor Wolf and policymakers to make a $25 million investment in CTE in the upcoming 2022-23 state budget.
CPSTF 2020 Annual Report to Congress
The Community Preventive Services Task Force (CPSTF) has released its 2020 Annual Report to Congress.
The report summarizes the CPSTF’s work from fiscal year 2020 and includes recommendations for intervention approaches that address health equity, HIV prevention or tobacco and economic reviews of previously recommended interventions that address cardiovascular disease or cancer screening. The report also lists critical evidence gaps identified by the systematic reviews and highlights the priority topics CPSTF selected to guide future reviews from 2020 to 2025.
Methods to Mitigate Systemic Racism in Clinical Preventive Services
The U.S. Preventive Services Task Force (USPSTF) has published an article titled, “Actions to Transform U.S. Preventive Services Task Force Methods to Mitigate Systemic Racism in Clinical Preventive Services,” in the Journal of the American Medical Association (JAMA). The article details action the Task Force is taking to promote antiracism and health equity in preventive care by confronting these issues throughout its recommendation development process. These efforts are aimed at reducing the effects of social injustices in health care and, ultimately, helping better equip clinicians with the evidence-based guidance they need to prevent disease and keep everyone as healthy as possible.
Leveraging Primary Care, Public Health & Social Assets
The Primary Care Collaborative (PCC) has released an annual research report for 2021, Primary Care and COVID-19: It’s Complicated-Leveraging Primary Care, Public Health, and Social Assets. In their first broad report on COVID-19, the PCC examines community factors at the county level—starting with primary care but also including local public health and social assets—to determine if these factors can help mitigate the effects of the pandemic and other health emergencies.
2020 Showed Steep Declines in U.S. Life Expectancy
The United States had the second-steepest decline in life expectancy among high-income countries in 2020, according to research published last week. U.S. men saw life expectancy fall by 2.3 years, from about 76.7 to 74.4. Women lost more than 1.6 years, falling from about 81.8 to 80.2. Researchers compared observed life expectancy in 2020 with what would have been expected for the year based on historical trends from 2005-2019. Life expectancy dropped in 31 of the 37 countries studied. Only Russia had a steeper decline than the U.S.
FDA Recalls Ellume At-Home COVID Tests
The U.S. Food and Drug Administration has announced a recall of about 2 million at-home COVID-19 test kits made by the Australian-based biotech company Ellume, indicating the test kits may produce “false positives” due to a manufacturing defect. The defective tests were manufactured by Ellume between Feb. 24, 2021 and Aug. 11, 2021. So far, 35 false positives from these tests have been reported to the FDA. Earlier this year, the Biden administration cut a $231.8 million deal with Ellume to boost the availability of the tests in the U.S. market.
Ellume says it has corrected the manufacturing problem and the FDA says it is continuing to monitoring the company’s efforts.